Bill > H4335

This bill requires various health insurance providers in Massachusetts to offer comprehensive coverage for individuals with an acquired brain injury (ABI), which is defined as any brain injury occurring after birth from causes such as stroke, disease, or trauma. The bill mandates that insurance plans cover a wide range of medically necessary treatments, including cognitive rehabilitation therapy, neurocognitive therapy, neuropsychological testing, community reintegration services, and post-acute residential treatment. These treatments aim to help individuals re-learn essential cognitive skills, improve communication, develop compensatory strategies, and successfully reintegrate into daily life, employment, and community settings. The legislation ensures that these services cannot be subject to unreasonable lifetime or annual limitations, cannot be denied solely based on the treatment location, and must not have higher out-of-pocket costs compared to other medical benefits. Additionally, the bill requires insurance companies to provide adequate training to personnel handling pre-authorization and utilization review, in consultation with the Brain Injury Association of Massachusetts. Practitioners and treatment facilities must be appropriately licensed and accredited, including having programs regulated by the Executive Office of Health and Human Services and accredited by the Commission on Rehabilitation Facilities (CARF) with a Brain Injury Specialty Program.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H4335